Little critical socio-cultural work focuses on people considered to have speech impairments. Yet, verbal communication remains a privileged norm. Research suggests that whatever other barriers significantly disabled people experience -- and dysarthric speech almost always comes with other impairments -- speech issues are primary. Spasticity and involuntary movements may or may not contribute significantly to the shaping of our social interactions. However, communication impairment is necessarily and urgently a public matter. Speech is, most fundamentally, how we make our private selves public so that we may effectively interact with the world around us. The desire to communicate has involved incredible creativity. Most obviously, various technologies, now mainstream, such as voice recognition and mobile text to text, started in the disability community. Some believe that technology will solve all communication disability problems. A fuller analysis suggests that communication technologies, many having an origin in the disability community, will change all our behavior. Communication technologies for people with speech impairments may change how we all “listen.” This can already be demonstrated where there are common innovations in inclusion of disabled and elderly in mobile “phone” and emergency technologies. This analysis will take us past research questions about strategies that “compensate” or “accommodate” to speech impairment on the individual level, to consider what does it mean for “universal design” or “inclusive design” to encompasses non-standard speech. What innovations will change how we all ”speak” and listen?”